Blood Patch
11/06/2019
NOTE: For any patient (regardless of age) having a spinal injection of any type or if the patient is over 65 yrs of age, they must have had a PT/PTT/INR and platelet count (with acceptable results) drawn within 3 months of the scheduled procedure. If the patient has a diagnosis of liver disease, labs must be within the past 1 month.
EXCEPTIONS: Any patients of Chattanooga Bone and Joint, i.e. Dr.’s Redish, Bruce, Lund or Lowry do not need labs.
PREP: Refer to Lab Work Procedure Page to determine which drugs need to be discontinued and for how long. Patient must have driver ready.
FORMS REQUIRED: Contrast Questionnaire; Consent for Procedure; Discharge instructions; Prior LP Report
PATIENT HISTORY: Previous injections or procedures on spine and when? (If patient had a myelogram, check the report to see at what level it was done)
STERILE TRAY SETUP: Use myelogram tray
Add: 25 gauge 1 ½” (orange) needle
10 cc syringe x 2 (for waste and patch)
For Sabourin and Sud: also add 22 gauge Tuohy Needle
Using 10 cc syringe and 18 gauge 1 ½” (pink) needle – draw up 9 cc lidocaine and 1 cc sodium bicarbonate. If using individual vials, use 8:1 or 4 vials.
Attach 25 gauge 1 ½”(orange) needle to lidocaine syringe
Using 20 cc syringe and 18 gauge 1 ½” (pink) needle – draw up 5 cc Omnipaque 180
Note: Be accurate with contrast – intra-thecal (into the subarachnoid space of the spinal cord) use only.
Attach 20 cc syringe of contrast mixture to short tubing(long tubing for Dr. Talley) and fill to remove air bubbles
Pour alcohol onto 4x4s
Place hemostats, sharpie and sterile gloves on counter for Radiologist
Place Rt or Lt marker (with correct orientation) on underside of tube
PROCEDURE: Radiologist will inject and do fluoro images. Afterward, patient will go to recovery room (ask Radiologist how long patient needs to stay).
NOTE: Record contrast amount and type used as well as fluoro time on tech notes and in Nuance system.